Guttercat

Fantastic article! Thank you, Linda!

Thank you so much for the insight, subee. The grass is not necessarily greener, as it is said. Sounds a lot like my gig. Yes, I loved what I did, but it was a love/hate thing. Many hours on-call, and getting hauled out of bed at 11PM when your head finally hits the pillow is a big fat drag.

Back in my Day: Reflections from a Crusty Old Bat Thirty-one years ago, I graduated as a baby-nurse and sat my boards. This was back when a graduate nurse actually sat boards with two or three hundred of their closest friends from across the state in one large hall, and testing took two full days. The camaraderie was intense; it was a right of passage. What's interesting is that in 31 years of continuous nursing in multiple environments, the ER is essentially the same, ICU is essentially the same, and med-surg is essentially the same. What hasn't changed is new nurses floundering and wanting to quit within the first seven years. Here's my suggestion to you youngsters either in school, or in your first few years of active practice: Pay very close attention to what tripped your trigger in nursing school, no matter how seemingly insignificant at the time. Think about it: there was probably one little moment in clinicals where something surprised you and made you curious, and that "something" felt natural, even if it felt alien. Follow that gut instinct. Thirty-one years later and my what I regret most is that I never became a CRNA. One of my fondest memories in nursing school was in OR. I thought I would be fascinated by the surgery itself, but, much to surprise, I instead pestered the anaesthesiologist the entire surgery. I eventually end up in a specialty that is somewhat closely related, but it took a long time to get there after I floundered around for several years. I am at the end of my career, now, and it's been a really great run, but it could have been so much better if I'd paid attention to that tiny little spark from so long ago. Best wishes to all the newbies, and, in the words of one of my professors, "go forth and do great things.”

There might be a correlation to a possible causation (which shall be unnamed). Maybe create a hypothesis based on observation, and do a little digging and data collection? Could be an interesting project.

First, is this an AV graft? Or an actual fistula? Where is it located, and what vessels are involved? Second, have you referred to your facility's policy regarding needle spacing parameters?

A few years back I gave the wrong med to the wrong patient. Thankfully there was no horrendous outcome, but there just as easily could have been. It was all on me, because even though I can cite how bananas the day had been (picture tossed salad being tossed for hours on end and then toss it some more) and I was already exhausted, the fact remains I took a shortcut and bypassed a safety measure and gave the patient a drug meant for the patient in the adjacent bay. I am to this day still haunted by the "what if's" if the med I gave had had a severely negative outcome for the patient. So part of me can understand how anyone, under duress, can have poor judgement, but another part of me questions why she would want to return to nursing after her poor judgement resulted in patient death.

To be an effective and trusted leader on the floor, you must be proficient in not only "sticking" patients, but you must also understand all the physiology behind what can go wrong with the myriad graft and fistula configurations in modern surgical techniques. Being assigned the "float" and "med" nurse position will turn you into a glorified CNA with awesome computer skills.

The "hot stove" topic. I am not surprised no one has replied yet; most especially as a 'forced retiree' (we are many). I have many thoughts regarding vaccination against a coronavirus in the young as well as the mass vaccination approach the world took against a coronavirus. But I am tired. The window of opportunity for putting the brakes on who should and should not be vaccinated occurred a year-and-a-half ago. The train left the station and we are all on it now.

UK is hot on their heels. About time.

Dr. Dhand is no slouch.

Sciencedude, I am glad that you are looking at all sides. Cooler heads prevail. You are not alone.

The level of disdain and utter lack of professional civility in your response to reasoned concerns with bona-fide references (not solely a Youtube video) tells me all I need to know.